Christian bioethicists and theologians find themselves in a bind when it comes to gender transitions for transgender persons. On the one hand, it’s clear that gender dysphoria is a painful, sometimes fatal, state of being which requires treatment and care. On the other hand, many have argued that gender transition is not a moral means of addressing gender dysphoria according to natural law approaches. I argue that a natural law approach to gender transition is much more complex than usually presented, and currently doesn’t offer specific medical guidelines for transgender persons. This lack of specificity is due to conflicting views about the ontology of biological sex and gender identity, as well as confusion surrounding the causes of gender dysphoria. Scientific evidence seems to support numerous, incompatible accounts of gender dysphoria, suggesting that transgender identity is probably not a monolithic phenomenon with a single cause. For all these reasons, a natural law approach to transgender identity and gender transition is going to be slow to yield definitive moral prohibitions.

Current arguments against gender transition are limited in a few ways. First, discussion centers on “bottom surgery” without addressing social transitions or hormonal transitions. Second, they assume that transgender experience can only be conceptualized if relying on a body-soul dualism, which betrays a lack of engagement with many accounts put forth by transgender persons. Third, they assume a binary conception of biological sex which, in turn, renders intersexuality a disordered state. Fourth, they are quick to dismiss certain empirical studies without critical engagement. In short, the debates over gender transitions need clarification and better critical engagement if we are to have a convincing, theologically-informed moral stance on the issue.

I offer two suggestions moving forward. First, I suggest that theologians and bioethicists address the limitations in current arguments that I’ve outlined. Second, I suggest that we inquire into how bodily identity comes to be formed and reformed. This requires a turn to the phenomenology of gender dysphoria, as well as the phenomenology of embodiment more generally. Moral consciousness is itself tied up with embodied experience, thus serious engagement is needed with both the moral consciences of those with gender dysphoria who have decided not to transition, and those who have. Such accounts prevent an overly physicalist approach by allowing our interpretations of physical phenomena to be considered in tandem with the lived experience of the person and the social meanings of gender.